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What’s stopping us from rehabilitating mentally ill offenders?

I wanted to share with you some key takeaways from the findings of my dissertation; “Understanding Positive Risk-Taking and Barriers to Implementation in Forensic Mental Health.”
For context, positive risk taking is the process of supporting recovery and rehabilitation by actively and carefully engaging service users in decisions and activities that have previously posed a risk, in full acknowledgement of that risk, in the hope it has a positive outcome and builds new skills.
My thematic structure from 5 interviews with forensic healthcare professionals is below for reference.
| Theme | Subtheme |
| Engaging the Service User | – Offering, Accepting, Assessing – Staffing Safe Opportunities |
| Professional Development and Confidence in Practice | – Specialised Training and Professional Development – Confidence in Practice and Taking Responsibility – Challenging Anti-Progressive Attitudes |
| Navigating the Unique Needs of the Service User Group | – Acknowledging and Communicating Risk – Severe, Enduring and Fluctuating Conditions – Stuck in the System – The Juxtaposition of Justice |
Engaging the service user is around the safe engagement of the service user within this process:
- Service users are not being engaged in their own risk assessment which would allow them to build up skills in identifying and managing their own risk.
- Seclusion is being used for more ‘difficult’ to manage service users to compensate for low staffing which is detrimental to service user progress and a huge ethical problem.
Professional Development and Confidence in Practice discussed the complexities of training to work in forensic care and the fear around being responsible for decisions that could go very wrong.
- My participants expressed concerns that primarily clinical practitioners (i.e. clinical psychologists over forensic psychologists) may not be able to work as sufficiently with forensic clients as their training backgrounds and treatment models may favour either the judicial process or the therapeutic outcome, and whilst both are needed, it is unlikely to be available.
- Healthcare professionals also battle with colleagues who are not on board with the approach of offering positive risks, sometimes due to fear, others to not believing that the experience should positive due to the reasons a person is there.
Navigating the Unique Needs of the Service User Group discusses the nuances of forensics and what makes this service different to others.
- It is identified that some professionals find it more difficult to engage in and justify positive risks when it involves certain (overrepresented) conditions, such as psychosis, and certain offenses (sexual), particularly if there are vulnerable victims, which may impact treatment opportunities regardless of other ‘good’ factors.
- Information handed over from the criminal justice system to healthcare system is often dehumanising, reductionist and causes exaggerated risk levels which increases fear and safety behaviours from healthcare staff.
- Service users are subject to the conditions and restrictions of both the healthcare services and the criminal justice system which can present conflicting interests and outcomes from each institution. Additionally, the decisions made by the criminal justice system are often done so despite caseworkers never having met or worked directly with the service user, inhibiting healthcare professionals from using their professional judgement to offer positive risk-taking opportunities.
- Service users are very often ‘in the system’ for a long time, so much so that they may begin to fear life outside of an institution and may sabotage their own progress in order to stay within a familiar institution and possibly even to go back to prison.
Much more needs to be done, and needs to change to improve this increasingly prevalent service. It is my hope that more research within this area will help to support the recovery and rehabilitation of those who are cared for in forensic mental health settings and that my findings might inspire anyone who goes on to work with mentally ill offenders to make improvements to what they find in their workplace. Whilst my study was primarily within the secure healthcare space, much is transferrable to other areas of the criminal justice system.
Teaching, Technology, and reality

I’m not a fan of technology used for communication for the most part, I’d rather do things face to face. But, I have to admit that at this time of enforced lockdown technology has been to a large extent our saviour. It is a case of needs must and if we want to engage with students at all, we have to use technology and if we want to communicate with the outside world, well in the main, its technology.
However, this is forced upon us, it is not a choice. Why raise this, well let me tell you about my experiences of using technology and being shut at home! Most, if not all my problems, probably relate to broadband. It keeps dropping out, sometimes I don’t notice, that is until I go to save my work or try to add the final comment to my marking. I know other colleagues have had the same problem. Try marking on Turnitin only to find that nearly all of your feedback has just disappeared in a flash. Try talking to colleagues on Webex and watch some of them disappearing and reappearing. Sometimes you can hear them, sometimes you can’t. And isn’t it funny when there is a time lag, a Two Ronnies moment when the question before the last is answered. ‘You go, no you go’, we say as we all talk over each other because the social cues relied on in face to face meetings just aren’t there. I’ve tried discussion boards with students, it’s not like WhatsApp or Messenger or even text. It is far more staid than that. Some students take part, but most don’t and that in a module where attendance in class before the shutdown was running at over seventy per cent. I’m lucky to get 20% involved in the discussion board. Colleagues using Collaborate tell me a similar tale, a tale of woe where only a few students, if any appear. Six hours of emptiness, thumb twiddling and reading, that’s the lecturer, not the students.
Now I don’t know whether my problems with the internet are resultant of the increased usage across the country, or just in my area. I suspect not because I had problems before the lockdown. I live in a village and whilst my broadband package promises me, and delivers brilliant broadband speed at times, it is inconsistent, frequently inexplicably dropping out for a minute or two. It is frustrating at times, even demoralising. I have a very good laptop (supplied by the university) and it is hardwired in, so not reliant on Wi-Fi, but it makes little difference. I suspect the problems could be anywhere in the broadband ether. It could be at the other end, the university, it could be at Turnitin for instance or maybe its somewhere in a black hole in the middle. Who knows, and I increasingly think, who cares? When my broadband disappeared for a whole day, a colleague suggested that I could tether my phone. A brilliant idea I thought as our discussion became distorted and it sounded like he was talking to me from a goldfish bowl. I guess the satellite overhead moved and my signal gradually disappeared. I can tell you now that my mobile phone operator is the only one that provides decent coverage in my area. Tethered to a goldfish bowl, probably not a solution, but thanks anyway.
If I suffer from IT issues, then what about students? We are assured that those that live on campus have brilliant Wi-Fi but does this represent the majority of our student body? Not usually and certainly not now. Do they all have good laptops; do they all have a decent Wi-Fi package? I hazard a guess, probably not. But even if what they have is on par with what I have available to me could they not also be encumbered with the same problems? We push technology as the way forward in education but don’t bother to ask the end user about their experience in using it. I can tell you from student feedback that many don’t like Collaborate, find the discussion boards difficult to engage with and some are completely demotivated if they cannot attend physical classes. That’s not to say that all students feel this way, some like recorded lectures as it gives them the opportunity to watch it at their leisure, but many don’t take that final step of actually watching it. They intend to, but don’t for whatever reason. Some like the fact that they can get books electronically, but many don’t, preferring to read from a hard copy. Even browsing the shelves in the library has for some, a mystical pleasure.
I’ll go back to the beginning, technology has undoubtedly been our saviour at this time of lockdown, but wouldn’t it be a real opportunity to think about teaching and technology after this enforced lockdown? Instead of assuming all students are technology savvy or indeed, want to engage with technology regardless of what it is, should we not ask them what works for them. Instead of telling staff what they can do with technology, e.g. you can even remotely mark students’ work on a Caribbean island, should we not ask staff what works? Let’s change the negative narrative, “you’re not engaging with technology”, to the positive what works in teaching our students and how might technology help in that. Note I say our students, not other students at other universities or some pseudo student in a theoretical vacuum. We should simply be asking what is best for our students and a starting point might be to ask them and those that actually teach them.
Thinking “outside the box”

Having recently done a session on criminal records with @paulaabowles to a group of voluntary, 3rd sector and other practitioners I started thinking of the wider implications of taking knowledge out of the traditional classroom and introducing it to an audience, that is not necessarily academic. When we prepare for class the usual concern is the levelness of the material used and the way we pitch the information. In anything we do as part of consultancy or outside of the standard educational framework we have a different challenge. That of presenting information that corresponds to expertise in a language and tone that is neither exclusive nor condescending to the participants.
In the designing stages we considered the information we had to include, and the session started by introducing criminology. Audience participation was encouraged, and group discussion became a tool to promote the flow of information. Once that process started and people became more able to exchange information then we started moving from information to knowledge exchange. This is a more profound interaction that allows the audience to engage with information that they may not be familiar with and it is designed to achieve one of the prime quests of any social science, to challenge established views.
The process itself indicates the level of skill involved in academic reasoning and the complexity associated with presenting people with new knowledge in an understandable form. It is that apparent simplicity that allows participants to scaffold their understanding, taking different elements from the same content. It is easy to say to any audience for example that “every person has an opinion on crime” however to be able to accept this statement indicates a level of proficiency on receiving views of the other and then accommodating it to your own understanding. This is the basis of the philosophy of knowledge, and it happens to all engaged in academia whatever level, albeit consciously or unconsciously.
As per usual the session overran, testament that people do have opinions on crime and how society should respond to them. The intriguing part of this session was the ability of participants to negotiate different roles and identities, whilst offering an explanation or interpretation of a situation. When this was pointed out they were surprised by the level of knowledge they possessed and its complexity. The role of the academic is not simply to advance knowledge, which is clearly expected, but also to take subjects and contextualise them. In recent weeks, colleagues from our University, were able to discuss issues relating to health, psychology, work, human rights and consumer rights to national and local media, informing the public on the issues concerned.
This is what got me thinking about our role in society more generally. We are not merely providing education for adults who wish to acquire knowledge and become part of the professional classes, but we are also engaging in a continuous dialogue with our local community, sharing knowledge beyond the classroom and expanding education beyond the campus. These are reasons which make a University, as an institution, an invaluable link to society that governments need to nurture and support. The success of the University is not in the students within but also on the reach it has to the people around.
At the end of the session we talked about a number of campaigns to help ex-offenders to get forward with work and education by “banning the box”. This was a fitting end to a session where we all thought “outside the box”.







